The United Nations has warned that the growing trafficking of medicines poses a major public health threat across Central Africa, driven by inadequate access to safe and affordable healthcare.

A new report by the United Nations Office on Drugs and Crime (UNODC), the World Health Organisation (WHO) and the Central African Economic and Monetary Community (CEMAC) said the illicit trade was flourishing partly because essential medicines were often unavailable or too expensive.

The six CEMAC countries – Cameroon, Central African Republic, Chad, Republic of Congo, Equatorial Guinea and Gabon – face a high burden of infectious diseases, including tuberculosis, malaria and HIV.

The report said traffickers divert prescription medicines from regulated supply chains and national health programme stocks, while also distributing counterfeit, substandard and unapproved products.

The medicines include antibiotics, antimalarials, painkillers, anti-inflammatory drugs and psychoactive substances such as tramadol and pregabalin.

Authorities in the six countries seized at least 251 tonnes of medicines between 2020 and 2025, according to the report.

The UNODC warned that the illicit trade could result in treatment failures, poisoning and preventable deaths, while also strengthening organised crime and weakening public institutions.

The report said some illicit medicines eventually entered legitimate healthcare facilities, despite patients generally regarding such institutions as reliable sources of medical treatment.

It added that illicit medicines were commonly brought into the region through seaports and river ports, as well as by air in cargo and passengers’ luggage, before being distributed through major trade routes.

In the Central African Republic, armed groups were reportedly profiting from the trade by looting health centres and imposing taxes on shipments passing through areas under their control.

The report also highlighted the scale of the public health consequences. WHO estimates cited in the report indicate that falsified or substandard antimalarial medicines may be associated with between 72,000 and 267,000 deaths annually in sub-Saharan Africa, while poor-quality antibiotics used to treat childhood pneumonia may be linked to up to 169,271 deaths each year.

The UN agencies called for stronger cooperation among Central African countries, improved regulation of medical supply chains and greater efforts to ensure that safe and affordable medicines are accessible to communities.

They said addressing the underlying gaps in healthcare access would be critical to reducing demand for illicit medical products and weakening the criminal networks that profit from the trade.